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Electrode Pads Information

Information about Defibrillator / AED electrode Pads
  • The differences between the various Zoll electrode pads

    zoll-electrodesThese pads are suitable for the Zoll AED Plus and the Zoll AED Pro. Which ones should you choose?  In the overview below we have set out the differences that may help to make your choice easier.

    Click here to view the Zoll electrode pads in our web shop.
     As you can see there are 4 types. All of these electrode pads can be used with the Zoll AED Plus and the Zoll AED Pro and are interchangeable with the professional monitors/ defibrillators from Zoll that are used by ambulance services. All these sets can be used once only. After they have been removed from their sealed package they must be used straightaway.  Electrode pads have a limited shelf life because the conductivity of the adhesive gel that will decrease with time.

    Zoll CPR/D Padz (art.8900-0800-01)
    These pads are the preferred pads for the Zoll AEDs as they have been developed for maximum  convenience. Each pad has been made from one piece, which makes accurate positioning easier. These pads have a sensor that measure the depth of the chest compressions. The AED responds to these measurements by giving extra instructions such as ‘press harder’. Better chest compressions will help to increase the chances of survival. The CPR/D pads have a 5 years shelf life. This explains the higher purchase price compared to the other Zoll electrode pads. These electrode pads are  intended for adults.

    Zoll CPR Stat Padz (art.8900-0400)
    The CPR Stat Padz are not made out of one piece like the CPR/D pads, but are provided with a sensor. These pads are made for the aid worker who welcomes extra instructions but not one-piece pads. These electrodes may also prove advantageous when the AED is used regularly. Their price is lower, all functionality is preserved and their shorter shelf life (about 2 years) is less important. These sets are intended for adult uses.

    Stat Padz II (art. 8900-0801-01 Zoll)
    Stat Padz are sold widely to people who have no interest in the CPR-feedback of the Zoll AEDs; no sensor is attached to the pads and there is no feedback. This product is made for the very CPR experienced aid worker who would not benefit much from CPR feedback. The electrodes are only connected to each other through a cable and are therefore not made out of one piece. These are the most favourably priced electrode pads and have a shelf life of approximately two years.

    Zoll Pedi Padz (art. 8900-0810-01)
    The Pedi Padz are intended for children up to 8 years of age or about 25 kg of body weight.These electrodes guide the energy level of the shock downwards in order to provide optimum therapeutic benefit to smaller bodies.  It is good practice to keep paediatric pads in the vicinity of the AED when it is kept  in a place where many children are present.

     

  • Children and circulatory arrest

    child-electrodes

    When a small child (<25 kg) has a circulatory arrest, this usually has a different starting cause than a fibrillating heart. Examples of this are:
    - suffocation
    - drowning

    The right treatment in this case is:
    - dial 999 or 112
    - start CPR

    Because it is not always clear what caused the circulatory arrest the AED unit will always have to be brought.

    If a victim weighs less than 25 kg the use of child pads is recommended but not required.

    Reasons for using child pads are:

    • the AED uses a special child-database for the heart analysis (that is because the regular heart rhythm of a small child is faster or even much faster than for an adult);
    • the surge of the AED will revert from 150 Joule to 50 to 80 Joule.

    The adjustment of the database, protocol and Joules varies per brand. This document is based on the Philips AED’s

    Reasons not to use child pads are:

    • having to change electrodes in the middle of a panic situation, which can lead to delays.

    A child key or switch button can be a solution;

    • the AED can also be used with adults’ electrodes for use on children who weigh less than 25kg.
    • The Dutch Resuscitation Council writes in the currently applicable guidelines: Standard AEDs may also be used for defibrillation of infants and children if there is no custom AED available for them.
    • with children under 25kg circulatory arrest in which fibrillation is the cause is less than 5x a year.

    Summarizing:
    It is better for a child to use child pads, but in emergencies the standard AED should be used.

    Remark: for children under 25kg the pads will have to be patched in a different way. See the picture below (one electrode pad on the rear between the shoulder blades and one electrode pad on the breastbone between the nipples: The hands should in this case be placed on the electrode pads during resuscitation).

  • What is the reason AED electrode pads have a limited shelf life?

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    You must have noticed when you have an AED that the electrode pads have a limited shelf life. What is the reason for this?

    The function of AED electrode pads

    The pads have two main functions.  Attached to the AED the pads measure the heart rhythm to judge if a life-saving shock is required.  If the AED recommends a shock must be given then it will give a therapeutic shock using the same electrode pads. For use of these main functions  firm adhesion to the  skin is of great importance.

    The electrode pads use an adhesive gel that conducts

    For  purpose of adhesion to the skin electrode pads are equipped with a gel that not only has adhesive properties but also conducts the electric current. After a while the gel on the pads may dry out in the packaging, causing the chemical composition of the gel to change.  This will  result in  lower conduction of the electric current.  The AED may have problems with the analysis if the quality of the conducting signal reduces.  Also the electrode pads will be less adhesive. This can be a problem when chest compressions have to be applied. They may shake loose from the skin or become displaced. The AED will then be less able of providing a therapeutic shock, hence reducing its life-saving function.

    The solution

    Because of changes in the chemical composition of the pads the manufacturer can guarantee their quality only for a specific period of time after production. This is the reason that the pads are supplied with a “best before date”. The shelf life varies, depending on the brand and type and runs from 12 to 60 months. It is important that during the periodic inspection of the AED the electrode pads are also checked and, where necessary replaced.

  • Taking the Mystery out of Maintenance

    RCUK-logo_banner4ERC_logo_2011QQ20140818-1From time to time, you will need to replace components of your AED or restock first aid items in your Safety Kit.

    How Often to Check Your AED
    AEDExpert recommends that you perform a monthly inspection of your AED device. You want to ensure that the:

    • Green light is still flashing on the front of the device.
    • No damage has been done to device.
    • None of the parts need to be replaced, etc.

    In the user guide that is included with your AED, you’ll find an inspection log, a plastic protective pouch to store the log, and a guide that will instruct you on how to perform monthly inspections.

    AED Self-Checks to Ensure Optimal Performance
    In the meantime, your AED will conduct daily self-checks to ensure that all of its components are functioning properly. If your AED detects a problem, it will make a beeping noise.

    Your AED will come with a user manual, Inspection Log / Maintenance Tips booklet. It will give you step-by-step instructions on how to address the issue that the AED has identified.

    When to Consider Replacement Parts for Your AED
    To ensure that your AED is ready to use when you need it, you should replace certain parts from time to time. Please note, it is your responsibility to keep track of replacement dates and expiration dates. To help you keep track of dates, your AED comes with a small pre-printed sticker that includes an “Installation Date” and “Expiration Date” for the battery and pads.

    AEDexpert recommends that you order an extra battery and pads, so you have them handy.

    Here is a general replacement timeline for your AED components:

    • Battery: Replace four years* (unless otherwise stated) after the installation date. Once you install your battery, it should last for four years*. We recommend that you take a Sharpie marker and write “Installation date: [your date]” on your battery. (Please note, the battery comes with an “Install By” date pre-printed on it. However, the four-year battery life actually starts once it has been installed, not with the “Install By” date.)
    • Pads: Replace on the two-year expiration date, as well as after each use. Your AED pads have a two-year life span. The pads come pre-printed with an expiration date.
    • AED heart defibrillator: Replacement depends on the self-checks. The useful life of an AED is 10 years — as long as it passes the daily self-tests. When the AED device no longer passes the daily self-tests, it’s time to replace it. Your AED device is covered by warranty.
  • Guidelines for the use of AED's

    Introduction
    Guidelines for the use of automated external defibrillators (AEDs)
    by laypeople, first responders and healthcare professionals responding with an AEDoutside hospital. These guidelines are appropriate for all types of AED, including those that are fully automatic.

    In the UK approximately 30,000 people sustain cardiac arrest outside hospital and are
    treated by emergency medical services (EMS) each year. Electrical defibrillation is
    well established as the only effective therapy for cardiac arrest caused by ventricular
    fibrillation (VF) or pulseless ventricular tachycardia (VT). The scientific evidence to
    support early defibrillation is overwhelming; the delay from collapse to delivery of the
    first shock is the single most important determinant of survival. If defibrillation is
    delivered promptly, survival rates as high as 75% have been reported. The chances
    of successful defibrillation decline at a rate of about 10% with each minute of delay
    basic life support will help to maintain a shockable rhythm but is not a definitive
    treatment.

    Guideline changes
    There are no major changes to the sequence of actions for AED users in Guidelines
    2010. The ILCOR Consensus on Science and Treatment Recommendations makes
    the following recommendations which are relevant to the RC(UK) AED guidelines:

    1. An AED can be used safely and effectively without previous training.
    Therefore, the use of an AED should not be restricted to trained rescuers.
    However, training should be encouraged to help improve the time to shock
    delivery and correct pad placement.

    2. Short video/computer self-instruction courses, with minimal or no instructor
    coaching, combined with hands-on practice can be considered as an
    effective alternative to instructor-led BLS and AED courses. Such courses
    should be validated to ensure that they achieve equivalent outcomes to
    instructor led courses.
    3. When using an AED minimise interruptions in chest compression. Do not
    stop to check the victim or discontinue cardiopulmonary resuscitation (CPR)
    unless the victim starts to show signs of regaining consciousness, such as
    coughing, opening his eyes, speaking, or moving purposefully AND starts to
    breathe normally.

    Types of automated external defibrillator
    AEDs are sophisticated, reliable, safe, computerised devices that deliver electric shocks
    to victims of cardiac arrest when the ECG rhythm is one that is likely to respond to a
    shock. Simplicity of operation is a key feature: controls are kept to a minimum, voice
    and visual prompts guide rescuers. Modern AEDs are suitable for use by both lay
    rescuers and healthcare professionals.
    All AEDs analyse the victim’s ECG rhythm and determine the need for a shock. The
    semi-automatic AED indicates the need for a shock, which is delivered by the operator,
    while the fully automatic AED administers the shock without the need for intervention by
    the operator. Some semi-automatic AEDs have the facility to enable the operator
    (normally a healthcare professional) to override the device and deliver a shock
    manually, independently of prompts.
    Sequence of actions when using an automated external defibrillator
    The following sequence applies to the use of both semi-automatic and automatic AEDs
    in a victim who is found to be unconscious and not breathing normally.
    1. Follow the adult BLS sequence as described in the basic life support
    chapter. Do not delay starting CPR unless the AED is available
    immediately.
    2. As soon as the AED arrives:
    • If more than one rescuer is present, continue CPR while the AED is switched on. If you are alone, stop CPR and switch on the AED.
    • Follow the voice / visual prompts.
    • Attach the electrode pads to the patient’s bare chest.

    • Ensure that nobody touches the victim while the AED is analysing the rhythm.

    3A. If a shock is indicated:
    • Ensure that nobody touches the victim.
    • Push the shock button as directed (fully-automatic AEDs will deliver the
    shock automatically).
    • Continue as directed by the voice / visual prompts.
    • Minimise, as far as possible, interruptions in chest compression.

    3B. If no shock is indicated:
    • Resume CPR immediately using a ratio of 30 compressions to 2 rescue
    breaths.
    • Continue as directed by the voice / visual prompts.

    4. Continue to follow the AED prompts until:
    • qualified help arrives and takes over OR
    • the victim starts to show signs of regaining consciousness, such as
    coughing, opening his eyes, speaking, or moving purposefully AND starts to
    breathe normally OR
    • you become exhausted.

    Placement of AED pads
    Place one AED pad to the right of the sternum (breast bone), below the clavicle (collar
    bone). Place the other pad in the left mid-axillary line, approximately over the position of
    the ECG electrode. It is important that this pad is placed sufficiently laterally and that
    it is clear of any breast tissue.
    Although most AED pads are labelled left and right, or carry a picture of their correct
    placement, it does not matter if their positions are reversed. It is important to teach that
    if this happens ‘in error’, the pads should not be removed and replaced because this
    wastes time and they may not adhere adequately when re-attached.
    The victim’s chest must be sufficiently exposed to enable correct pad placement. Chest
    hair will prevent the pads adhering to the skin and will interfere with electrical contact.
    Shave the chest only if the hair is excessive, and even then spend as little time as
    possible on this. Do not delay defibrillation if a razor is not immediately available.

    Defibrillation if the victim is wet
    As long as there is no direct contact between the user and the victim when the shock is
    delivered, there is no direct pathway that the electricity can take that would cause the
    user to experience a shock. Dry the victim’s chest so that the adhesive AED pads will
    stick and take particular care to ensure that no one is touching the victim when a shock
    is delivered.

    Defibrillation in the presence of supplemental oxygen
    There are no reports of fires caused by sparking where defibrillation was delivered using
    adhesive pads. If supplemental oxygen is being delivered by a face mask, remove the
    face mask and place it at least one metre away before delivering a shock. Do not allow
    this to delay shock delivery.

    Minimise interruptions in CPR
    The importance of early, uninterrupted chest compressions is emphasised throughout
    these guidelines. Interrupt CPR only when it is necessary to analyse the rhythm and
    deliver a shock. When two rescuers are present, the rescuer operating the AED applies
    the electrodes while the other continues CPR. The AED operator delivers a shock as
    soon as the shock is advised, ensuring that no one is in contact with the victim.

    CPR before defibrillation
    Provide good quality CPR while the AED is brought to the scene. Continue CPR whilst
    the AED is turned on, then follow the voice and visual prompts. Giving a specified
    period of CPR, as a routine before rhythm analysis and shock delivery, is not
    recommended.

    Voice prompts
    The sequence of actions and voice prompts provided by an AED are usually
    programmable and it is recommended that they be set as follows:

    • deliver a single shock when a suitable rhythm is detected;
    • no rhythm analysis immediately after the shock;
    • a voice prompt for resumption of CPR immediately after the shock;
    • a period of 2 min of CPR before further rhythm analysis.

    AED use by healthcare professionals
    All healthcare professionals should consider the use of an AED to be an integral
    component of BLS. Early defibrillation should be available throughout all hospitals,
    outpatient medical facilities and clinics. Sufficient staff should be trained to enable a first
    shock to be provided within 3 min of collapse anywhere in the hospital. Hospitals should
    monitor collapse-to-first-shock intervals and monitor resuscitation outcomes. The RC(UK) advises that untrained employees working in healthcare establishments
    not be prevented from using an AED if they are confronted with a patient in cardiac
    arrest. The administration of a defibrillatory shock should not be delayed while waiting
    for more highly trained personnel to arrive. The same principle should apply to
    individuals whose certified period of qualification has expired.

    Storage and use of AEDs
    AEDs should be stored in locations that are immediately accessible to rescuers; they
    should not be stored in locked cabinets as this may delay deployment. Use of the UK
    standardised AED sign is encouraged, to highlight the location of an AED. People with
    no previous training have used AEDs safely and effectively. While it is highly desirable
    that those who may be called upon to use an AED should be trained in their use, and
    keep their skills up to date, circumstances can dictate that no trained operator (or a
    trained operator whose certificate of training has expired) is present at the site of an
    emergency. Under these circumstances no inhibitions should be placed on any person
    willing to use an AED.

    Children
    Standard AED pads are suitable for use in children older than 8 years. Special
    paediatric pads, that attenuate the current delivered during defibrillation, should be used
    in children aged between 1 and 8 years if they are available; if not, standard adult-sized
    pads should be used. The use of an AED is not recommended in children aged less
    than 1 year. However, if an AED is the only defibrillator available its use should be
    considered (preferably with the paediatric pads described above).

    Public access defibrillation (PAD)
    Public access defibrillation is the term used to describe the use of AEDs by laypeople.27
    Two basic strategies are used. In the first, AEDs are installed in public places and used
    by people working nearby. Impressive results have been reported with survival rates as
    high as 74% with fast response times often possible when an AED is nearby.23

    In a complementary strategy, first responders are dispatched by an ambulance control
    centre when they might reach a patient more quickly than a conventional ambulance.
    The greater delay in defibrillation resulting from the need for such responders to travel
    to a patient has been associated with more modest success rates. However, this
    strategy does enable treatment of people who arrest at home, the most common place for
    cardiac arrest to occur.

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